Canine Diabetes Wiki
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Actraphane 40/60
R/Neutral/NPH/Isophane Mix by Novo Nordisk
intermediate-acting r-DNA/GE/GM
U100 isophane
Line Novo
Also known as Mixtard 40, Penmix 40[1]
Similar to  
Action in dogs  
  • onset 0.5-3h,
  • peak 2-10h,
  • duration 4-24h
Use and Handling
Type cloudy
Shelf Life 30 months
When opened 6 weeks room temp.
In pen 6 weeks room temp.
Notes  
  • protect from light and heat
  • Do Not Freeze
  • Do not use if product does not re-suspend
  • Roll
  • Do not use intravenously
  • Do not refrigerate in use cartridges/pens.


40 60

Time activity profile for Actraphane 40/60.

An intermediate-acting, mixed insulin[2] of 40% R/neutral insulin and 60% NPH/isophane insulin[3] made by Novo Nordisk. Mixtard 40[4] contains 60% isophane insulin crystals.

This insulin is similar to Novo's Penmix 40 and Mixtard 40, which was was discontinued December 31, 2007.[5][6] It is also similar to the discontinued North American offering of Lilly-Humulin 40/60.

Mixed insulins cover a wide range as they can be animal origin, r-DNA/GE/GM origin or analog insulins. They can also vary in the fraction (amount or percent) of the two types (R/neutral and NPH/isophane) of insulin used to make a non-analog mix, and in the percentage of fast/rapid-acting analog insulin and slower-acting protamine suspended analog insulin.

For some reason, those in the US choose to list the slower, NPH/isophane based insulin fraction first, such as Humulin or Novolin 70/30. The rest of the world gives the faster insulin top billing and the result is 30/70[7]. Regardless of how this is written, it means that the insulin is made up of 70% NPH/isophane insulin and 30% R/neutral insulin.

The most common mixes are 70/30 (30/70) (non analog) or 75/25 (25/75) (analog). There are no currently-marketed mixes which combine insulins of different origins. Eli Lilly's form of beef/pork Iletin and Novo Nordisk's Lentard were discontinued some time ago. Here are the most common ones that could cause confusion:

Non-Analog Mixed Insulins
Expressed As Expressed As Insulin Is
10/90 90/10 10% R/Neutral Insulin
90% NPH/Isophane Insulin
20/80 80/20 20% R/Neutral Insulin
80% NPH/Isophane Insulin
30/70 70/30 30% R/Neutral Insulin
70% NPH/Isophane Insulin
40/60 60/40 40% R/Neutral Insulin
60% NPH/Isophane Insulin
50/50 50/50 50% R/Neutral Insulin
50% NPH/Isophane Insulin

References

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